Key result
Physical stress in bovine jugular vein recipients increased stroke volume by 61±49% and gradients from 24±11 to 40±20 mmHg, demonstrating that Contegra valves tolerate stress without performance drop.
Why the study?
Does physical stress alter the measured hemodynamic performance of bovine jugular vein conduits in young recipients?
Observational (n=20)
Does physical stress alter the measured hemodynamic performance of bovine jugular vein conduits in young recipients?
Bovine jugular vein valves tolerate physical stress without significant performance drop, though stress-induced hemodynamic changes necessitate constant examination conditions for accurate follow-up.
Answers are grounded in this paper and cite their sources.
Mandates standardized conditions for serial Contegra assessments; leaves open durability under repeated stress in observational cohorts.
Bovine jugular veins (BJVs) (Contegra) are valve-bearing pulmonary artery substitutes. Their valves have higher profiles than human pulmonary valves; this might result in less optimal performance. Therefore, we investigated the impact of stress and undersizing on conduit performance with ergometry, echocardiography and magnetic resonance imaging (MRI). Between April 2007 and June 2008, 20 BJV recipients (age 7.9-19.6 years) underwent spiroergometry and subsequent echocardiography; after due rest, ergometry was repeated and followed by MRI during recovery. A year later, exams were repeated. Data was evaluated as follows: comparison of stress related maximal individual valve performance changes (magnetic resonance: exercise induced average stroke volume changes by 61+/-49%; mean insufficiency increased by 2% in patients with <1% rest insufficiency and by 8% after rest insufficiency of >10%; the average rest gradient of 24+/-11 mmHg rose to 40+/-20 mmHg), and stratification of pooled observations by regurgitation fraction, insufficiency grades and z-values (insufficiency rose with increasing heart rate and decreasing stroke volume; undersizing increased gradients during recovery by 7+/-0.7 mmHg/z-value). Contegras high-profile valves tolerate stress without performance drop. Stress induced changes of insufficiency and gradient were clinically not significant, but sufficient to distort examination results; therefore, constant examination conditions are indispensable for a correct follow-up.
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Boethig et al. (2010) conducted an observational in Bovine jugular vein recipients (n=20). Physical stress (ergometry) vs. Rest was evaluated on Stress-related maximal individual valve performance changes. Physical stress in bovine jugular vein recipients increased stroke volume by 61±49% and gradients from 24±11 to 40±20 mmHg, demonstrating that Contegra valves tolerate stress without performance drop.
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